Knowing Words will be welcomed by sinologists, classicists, and scholars of comparative philosophy and literature.

: The semantic fields and root metaphors of "fate" in Classical Greece and pre-Buddhist China are surveyed here. The Chinese material focuses on the Warring States, the Han, and the reinvention of the earlier lexicon in contemporary Chinese terms for such concepts as risk, randomness, and (statistical) chance. The Greek study focuses on Homer, Parmenides, the problem of fate and necessity, Platonic daimons, and the "On Fate" topos in Hellenistic Greece. The study ends with a brief comparative metaphorology of metaphors (...) for the action of fate including command, division or allotment, and wheel or cycles of change. (shrink)

Chinese philosophy has long recognized the importance of the body and emotions in extensive and diverse self-cultivation traditions. Philosophical debates about the relationship between mind and body are often described in terms of mind-body dualism and its opposite, monism or some kind of "holism." Monist or holist views agree on the unity of mind and body, but with much debate about what kind, whereas mind-body dualists take body and mind to be metaphysically distinct entities. The question is important for several (...) reasons. Several humanistic and scientific disciplines recognize embodiment as an important dimension of the human condition. One version, the problem of mind-body dualism, is central to the history of both philosophy and religion. Some account of relations between body and mind, spirit or soul is also central to any understanding of the self. Recent work in cognitive and neuroscience underscores the importance of our somatic experience for how we think and feel. (shrink)

This collection illustrates the centrality of skill within ancient ethics, including ancient Chinese ethics, showing how skill or techne has been a touchstone from the beginning of philosophical thought. Covering Socrates' search for expertise in virtue, the Republic's 'craft of justice', Aristotle's delineation of the politike techne and the Stoics' 'art of life'. Divided into four sections on Plato, Aristotle, the Stoics and Chinese ethics, it brings together world-leading philosophers working across this broad topic. Yet it is not limited to (...) traditional figures and traditions, featuring essays on the importance of skill in lesser-known philosophers, such as Carneades and Antipater, and texts, such as the Zhuangzi. In doing so, it illustrates how skill, expertise and 'know how' are important in ethics, epistemology, philosophy of mind, philosophy of action and cognitive science. This collection of specially-commissioned chapters is the first to foreground skill as central to Ancient and Chinese ethics specifically making it an essential for anyone interested in the value of cross-cultural philosophy today. (shrink)

Mounting evidence documents the extraordinary toll on human health resulting from the consumption of unhealthy food products and physical inactivity. Diseases related to poor nutrition – such as diabetes, heart disease, stroke, and some cancers – are among the leading causes of disability and death in the United States. Poor diet and lack of exercise come second only to tobacco use in actual causes of preventable death in this country. It is estimated that 6% of all adult health care, 7% (...) of Medicare, and 11% of Medicaid expenditures are attributable to obesity. According to the Centers for Disease Control and Prevention, the direct medical cost associated with physical inactivity was nearly $76.6 billion in 2000.In response to America's growing obesity problem, local policymakers have been looking for legal strategies to adopt in their communities to encourage healthful behaviors. Taking the lead from the successful tobacco control movement, nutrition advocates are seeking strategies to “denormalize” unhealthy behaviors, rather than pursuing education-based approaches that encourage individuals to change their own personal behavior. (shrink)

Reasoning well about risk is most challenging when a woman is pregnant, for patient and doctor alike. During pregnancy, we tend to note the risks of medical interventions without adequately noting those of failing to intervene, yet when it's time to give birth, interventions are seldom questioned, even when they don't work. Meanwhile, outside the clinic, advice given to pregnant women on how to stay healthy in everyday life can seem capricious and overly cautious. This kind of reasoning reflects fear, (...) not evidence. (shrink)

The human species is more reliant on cultural adaptation than any other species, but it is unclear how observational learning can give rise to the faithful transmission of cultural adaptations. One possibility is that teaching facilitates accurate social transmission by narrowing the range of inferences that learners make. However, there is wide disagreement about how to define teaching, and how to interpret the empirical evidence for teaching across cultures and species. In this article I argue that disputes about the nature (...) and prevalence of teaching across human societies and nonhuman animals are based on a number of deep-rooted theoretical differences between fields, as well as on important differences in how teaching is defined. To reconcile these disparate bodies of research, I review the three major approaches to the study of teaching – mentalistic, culture-based, and functionalist – and outline the research questions about teaching that each addresses. I then argue for a new, integrated framework that differentiates between teaching types according to the specific adaptive problems that each type solves, and apply this framework to restructure current empirical evidence on teaching in humans and nonhuman animals. This integrative framework generates novel insights, with broad implications for the study of the evolution of teaching, including the roles of cognitive constraints and cooperative dilemmas in how and when teaching evolves. Finally, I propose an explanation for why some types of teaching are uniquely human, and discuss new directions for research motivated by this framework. (shrink)

Mounting evidence documents the extraordinary toll on human health resulting from the consumption of unhealthy food products and physical inactivity. In response to America's growing obesity problem, local policymakers have been looking for legal strategies that can be adopted in their communities to encourage healthful behaviors. In order to provide practical tools to policymakers, this article examines four possible venues for local policy change to improve the health of a community: the school environment the built environment () community facilities and (...) the point of sale environment. Finally, the article examines the use of taxes or fees as a means of paying for nutrition policy work as well as potentially reducing the consumption of unhealthy products. This article illustrates that local laws and policies can be a valuable tool in changing a community's environment in order to improve nutritional options and increase opportunities for physical activity. (shrink)

Does asking about trauma history create participant distress? If so, how does it compare with reactions to other personal questions? Do participants consider trauma questions important compared to other personal questions? Using 2 undergraduate samples (Ns = 240 and 277), the authors compared participants' reactions to trauma questions with their reactions to other possibly invasive questions through a self-report survey. Trauma questions caused relatively minimal distress and were perceived as having greater importance and greater cost-benefit ratings compared to other kinds (...) of psychological research in an undergraduate human subjects pool population. These findings suggest that at least some kinds of trauma research appear to pose minimal risk when compared to other minimal risk research topics, and that participants recognize the importance of research about trauma. (shrink)

Introduction to a special issue on unrealistic optimism.

Critical congenital heart disease screening is rapidly becoming the standard of care in the United States after being added to the Recommended Uniform Screening Panel in 2011. Newborn screens typically do not require affirmative parental consent. In fact, most states allow parents to exempt their baby from receiving the required screen on the basis of religious or personally held beliefs. There are many ethical considerations implicated with allowing parents to exempt their child from newborn screening for CCHD. Considerations include the (...) treatment of religious exemptions in our current legal system, as well as medical and ethical principles in relation to the rights of infants. Although there are significant benefits to screening newborns for CCHD, when a parent refuses for religious or personal beliefs, in the case of CCHD screening, the parental decision should stand. (shrink)

Autobiographical stories do not merely offer insights into someone’s experience but can constitute evidence or even serve as self-standing arguments for a given viewpoint in the context of public debates. Such stories are likely to exercise considerable influence on debate participants’ views and behaviour due to their being more vivid, engaging, and accessible than other forms of evidence or argument. In this paper we are interested in whether there are epistemic and moral duties associated with the use of autobiographical stories (...) in mental health debates. We argue that debate participants have a responsibility to assess a story as evidence or as an argument when the story is put forward to support a given viewpoint. We also make some preliminary suggestions about what can be done to ensure that the use of stories contributes to the variety of the resources available to debate participants without compromising the quality of the argumentation or increasing polarisation. (shrink)

This paper details the experience of planning, orchestrating, teaching, and participating in a writing-intensive, team-taught, introductory philosophy class designed to expand the diversity of voices included in philosophical study. Accordingly, this article includes the various perspectives of faculty, TAs, and students in the class. Faculty authors discuss the administrative side of the course, including its planning and goals, its texts and structure, its working definition of “philosophy,” its balance of canonical and non-canonical texts, the significant resistance met in getting the (...) course approved, the complex pedagogical difficulties that attend teaching non-canonical texts, the motivation and execution of the course’s writing-intensive dimension, and a summary of student evaluations of the course. The TA authors reflect on the high level of student engagement and interest compared to other introductory philosophy courses, the perception that students found the material highly relevant to their own lives, and the capacity of the material to bring about philosophical insight for the instructors in the class. The student author offers a favorable account of the class and remarks on how the structure of the course aided the accessibility and relevance of the texts. (shrink)

Bioethics increasingly recognizes the impact of discriminatory practices based on social categories such as race, gender, sexual orientation or ability on clinical practice. Accordingly, major bioethics associations have stressed that identifying and countering structural discrimination in clinical ethics consultations is a professional obligation of clinical ethics consultants. Yet, it is still unclear how clinical ethics consultants can fulfill this obligation. More specifically, clinical ethics needs both theoretical tools to analyze and practical strategies to address structural discrimination within clinical ethics consultations. (...) Intersectionality, a concept developed in Black feminist scholarship, is increasingly considered in bioethical theory. It stresses how social structures and practices determine social positions of privilege and disadvantage in multiple, mutually co-constitutive systems of oppression. This article aims to investigate how intersectionality can contribute to addressing structural discrimination in clinical ethics consultations with a particular focus on mental healthcare. To this end, we critically review existing approaches for clinical ethics consultants to address structural racism in clinical ethics consultations and extend them by intersectional considerations. We argue that intersectionality is a suitable tool to address structural discrimination within clinical ethics consultations and show that it can be practically implemented in two complementary ways: 1) as an analytic approach and 2) as a critical practice. (shrink)

A key debate about the nature and role of ecommerce centres around the question of whether it is merely an old activity in a new form, or a discontinuous process that rewrites the ideas and assumptions of the ‘old’ economy. The objective of this exploratory and qualitative study is to shed some light on this issue through the lens of business ethics. We will examine whether established ethical principles still apply to e‐commerce, or instead if the ‘rule book’ now needs (...) to be re‐written. (shrink)

(2001). Looking toward the future of clinical trials: The application of communication variables to the recruitment of women into breast cancer clinical trials. World Futures: Vol. 57, Future Trends in Communications Strategies, pp. 599-613.

In this piece, we articulate the "collaborative autoethnographic practice" we utilized to illustrate the complexities of mothering that involved: (a) individually writing autoethnographic narratives on mothering, (b) sharing these autoethnographic narratives in a public forum, (c) publicly discussing the heuristic commonalities across these autoethnographic narratives, (d) tying those commonalities back to the literature, and (e) revisiting the autoethnographic narratives for aspects of social critique where our autoethnographic narratives (intentionally or unintentionally) hegemonicaly reproduced cultural scripts. We argue that presenting knowledge of (...) mothering in this way, through collaborative autoethnographic practice, creates a myriad of opportunities for growth and self-reflexivity, and our stories illuminate a part of our existence that often remains unexamined in other methodologies. (shrink)

Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between (...) studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice. (shrink)

BackgroundMulti-centre studies generally cost more than single-centre studies because of larger sample sizes and the need for multiple ethical approvals. Multi-centre studies include clinical trials, clinical quality registries, observational studies and implementation studies. We examined the costs of two large Australian multi-centre studies in obtaining ethical and site-specific approvals.MethodsWe collected data on staff time spent on approvals and expressed the overall cost as a percent of the total budget.ResultsThe total costs of gaining approval were 38 % of the budget for (...) a study of 50 centres (mean cost AUD $6960 per site) and 2 % for a study of 11 centres (mean cost AUD $2300 per site). Seventy-five and 90 % of time was spent on repeated tasks, respectively, and many time-consuming tasks, such as reformatting documents, did nothing to improve the study design or participant safety.ConclusionsImprovements have been made to the ethical approval application system, but more gains could be made without increasing risks of harm to research participants. We propose that ethical review bodies and individual sites publish statistics on how long they take to process approvals which could then be nationally benchmarked. (shrink)

Over the last several years, as cesarean deliveries have grown increasingly common, there has been a great deal of public and professional interest in the phenomenon of women 'choosing' to deliver by cesarean section in the absence of any specific medical indication. The issue has sparked intense conversation, as it raises questions about the nature of autonomy in birth. Whereas mainstream bioethical discourse is used to associating autonomy with having a large array of choices, this conception of autonomy does not (...) seem adequate to capture concerns and intuitions that have a strong grip outside this discourse. An empirical and conceptual exploration of how delivery decisions ought to be negotiated must be guided by a rich understanding of women's agency and its placement within a complicated set of cultural meanings and pressures surrounding birth. It is too early to be 'for' or 'against' women's access to cesarean delivery in the absence of traditional medical indications – and indeed, a simple pro- or con- position is never going to do justice to the subtlety of the issue. The right question is not whether women ought to be allowed to choose their delivery approach but, rather, taking the value of women's autonomy in decision-making around birth as a given, what sorts of guidelines, practices, and social conditions will best promote and protect women's full inclusion in a safe and positive birth process. (shrink)

Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation across basic, translational and clinical research. Contemporaneously, tVNS can be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between (...) studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice. (shrink)

Person‐specific evidence was developed as a grounded theory by analyzing 20 selected case descriptions from interventions using the guided self‐determination method with people with various long‐term health conditions. It explains the mechanisms of mobilizing relational capacity by including person‐specific evidence in shared decision‐making. Person‐specific self‐insight was the first step, achieved as individuals completed reflection sheets enabling them to clarify their personal values and identify actions or omissions related to self‐management challenges. This step paved the way for sharing these insights and (...) challenges in a relationship with a supportive health professional, who could then rely on person‐specific evidence instead of assumptions or a narrow disease perspective for shared decision‐making. Trust in the evidence encouraged the supportive health professional to transfer it to the interdisciplinary team. Person‐specific evidence then enhanced the ability of team members to apply general evidence in a meaningful way. The increased openness achieved by individuals through these steps enabled them to eventually share their new self‐insights in daily life with other people, decreasing loneliness they experienced in self‐management. Relational capacity, the core of the theory, is mobilized in both people with long‐term health conditions and healthcare professionals. Further research on person‐specific evidence and relational capacity in healthcare is recommended. (shrink)

This new anthology of early modern philosophy enriches the possibilities for teaching this period by highlighting not only metaphysics and epistemology, but also new themes such as virtue, equality and difference, education, the passions, and love. It contains the works of forty-three philosophers, including traditionally taught figures such as Descartes, Spinoza, Leibniz, Locke, Berkeley, Hume, and Kant, as well as less familiar writers such as Lord Shaftesbury, Anton Amo, Julien Offray de La Mettrie, and Denis Diderot. It also highlights the (...) contributions of women philosophers, including Margaret Cavendish, Anne Conway, Gabrielle Suchon, Sor Juana Inéz de la Cruz, and Emilie Du Châtelet. (shrink)

Background: Nurses and midwives have a professional obligation to promote health and prevent disease, and therefore they have an essential role to play in vaccination. Despite this, some nurses and midwives have been found to take an anti-vaccination stance and promulgate misinformation about vaccines, often using Facebook as a platform to do so. Research question: This article reports on one component and dataset from a larger study – ‘the positives, perils and pitfalls of Facebook for nurses’. It explores the specific (...) issue of nurses and midwives who take an anti-vaccination stance, deemed to be unprofessional by crossing professional boundaries and by providing medical information on Facebook that is not within their scope of practice. Participants: Data were collected via an online worldwide survey from nurse and midwife participants, distributed and ‘snowballed’ through relevant nursing and midwifery groups on Facebook. In total, 1644 Registered Nurses and Midwives, and Enrolled Nurses worldwide attempted the online survey. There were 1100 completed surveys and 54 partially completed surveys. Semi-structured interviews were also conducted online using Skype® with 17 participants in Australia. Ethical considerations: Ethical processes and procedures have been adhered to relating to privacy, confidentiality and anonymity of the participants. Findings/results: A mixed-methods approach was used, including descriptive and content analysis of the quantitative survey data and thematic analysis of the qualitative interview data. The main theme ‘blurred boundaries’ was generated, which comprised three sub-themes: ‘follow the science, ‘abuse of power and erosion of trust’ and ‘the moral and ethical responsibility to safeguard public health’. The results offer an important and unique understanding of how nurses and midwives interpret the conduct of fellow health professionals as unprofessional and crossing the professional boundary if they used Facebook to promulgate anti-vaccination messages and/or give medical advice online. Conclusion: There are many positives and negatives for nurses and midwives associated with using Facebook for personal and professional communication, which is in keeping with the results of the larger study from which this article is taken. Professional behaviour is a key theme in the larger research as is the ethical construct of ‘every act has a consequence’; however, in this article, the theme ‘blurred boundaries’ offers an overall understanding of how nurses and midwives interpret the behaviour of their colleagues who espouse anti-vaccination sentiment and/or give medical advice online that is outside their scope of practice and education. (shrink)

Suicide among Veterans experiencing or at risk for homelessness remains a significant public health concern. Conducting research to understand and meet the needs of this at-risk population remains challenging due to myriad factors. To address this challenge, the United States Department of Veterans Affairs convened the Health Services Research and Development Suicide Prevention in Veterans Experiencing Homelessness: Research and Practice Development meeting, bringing together subject-matter experts in the fields of homelessness and suicide prevention, both from within and outside of VA. (...) During the meeting, attendees identified 10 potential research priorities at the intersection of suicide prevention and homelessness. After the meeting, Delphi methodology was used to achieve consensus on the relative importance of the identified research domains. Through this iterative Delphi process, agreement was reached regarding the need to increase understanding of barriers and facilitators to suicide risk assessment and emergency intervention for Veterans experiencing homelessness by examining the perspectives of both Veterans and healthcare providers. Elucidating the complex relationships between risk periods, subgroups, suicide means, and drivers of suicide among Veterans experiencing homelessness was also considered a top priority. This article documents the Delphi process and provides a research agenda for researchers, funding agencies, and policymakers to prioritize the most relevant and potentially impactful research domains aimed at preventing suicide among Veterans experiencing or at risk for homelessness. (shrink)

Between the Psyche and the Social is the first collection that specifically features the field of psychoanalytic social theory emerging in and between psychoanalysis, feminism, postcolonial studies, and queer theory, and across the disciplines of philosophy, literary, film, and cultural studies. This collection of essays takes the psychoanalytic study of social oppression in some new directions by engaging—indeed, stirring up—unconscious fantasies and ethical tensions at the heart of social subjectivity.

The plays written about AIDS in the past dozen years form a radical canon establishing gay men as the locus for public attention. These plays have been all but silent in their representation of women with AIDS. This article examines the marginalized women in early plays such as The Normal Heart and As Is, and the women more central to later plays such as The Baltimore Waltz, Before It Hits Home, and Patient A. It foregrounds some of the most problematic (...) issues surrounding the AIDS virus: the perception of women as vectors of disease for men and unborn children, the insistent representation of women as mothers and caregivers, and the denial of patterns of abuse, sexual exploitation, and poverty which contribute to the marginalization of woman and people of color. (shrink)

This book offers both the theoretical background behind the minority effect, teachers' personal experiences as they experienced being a minority, and their analyses and insights for teaching diverse learners. This book uses real-life experiences of diverse people to illustrate that, if not understood and addressed, situational minorities at school or work are unlikely to perform at their highest potentials.

Dispositional Essentialism, as commonly conceived, consists in the claims that at least some of the fundamental properties essentially confer certain causal-nomological roles on their bearers, and that these properties give rise to the natural modalities. As such, the view is generally taken to be committed to a realist conception of properties as either universals or tropes, and to be thus incompatible with nominalism as understood in the strict sense. Pace this common assumption of the ontological import of Dispositional Essentialism, the (...) aim of this paper is to explore a nominalist version of the view, Austere Nominalist Dispositional Essentialism. The core features of the proposed account are that it eschews all kinds of properties, takes certain predicative truths as fundamental, and employs the so-called generic notion of essence. As I will argue, the account is significantly closer to the core idea behind Dispositional Essentialism than the only nominalist account in the vicinity of Dispositional Essentialism that has been offered so far—Ann Whittle’s Causal Nominalism—and is immune to crucial problems that affect this view. (shrink)

This paper describes the first three-year experience of the Consortium Ethics Program (CEP-1) of the University of Pittsburgh Center for Medical Ethics, and also outlines plans for the second three-year phase (CEP-2) of this experiment in continuing ethics education. In existence since 1990, the CEP has the primary goal of creating a cost-effective, permanent ethics resource network, by utilizing the educational resources of a university bioethics center and the practical expertise of a regional hospital council. The CEP's conception and specific (...) components stem from recognition of the need to make each hospital a major focus of educational efforts, and to provide academic support for the in-house activities of the representatives from each institution. (shrink)

This paper is an intervention within feminist and queer debates that have re-posed so-called negative states of being as offering productive possibilities for political practice and social transformation. What is sometimes called the politics of negative affect or analyses of political feeling has sought to de-pathologise shame, melancholy, failure, depression, anxieties and other forms of ‘feeling bad’, to open up new ways of thinking about agency, change and transformation. Ann Cvetkovich's recent memoir explores depression as a public feeling and argues (...) that ‘feeling bad might, in fact, be the ground for transformation’. As she suggests, the question, ‘how do I feel’ could usefully be reframed as ‘how does capitalism feel’? This performative staging of political forms of psychosocial reflexivity opens up new strategies for survival, new visions of the future, and importantly de-medicalises feeling beyond an individual expression of psychopathology. The grounds for affective politics might be found within new feminist futures that are attentive to the relations between emotion, affect, feelings and politics. This paper will be situated within these debates and the challenge of thinking about the productive possibilities of negative states of being. However, rather than focus on depression, I will turn my attention to experiences such as psychosis and temporal dissociation, based on my long-standing research with the Hearing Voices Network. In the context of discussions of disability and capability I will discuss the value of concepts such as debility, and ‘living in prognosis’, and respond to the call to think through what such states might offer for feminist and queer practice. (shrink)

Graphical AbstractIn article number 1900223, Lennart Randau and co-workers present an overview of 2019's annual meeting of the German Genetics Society (Gesellschaft für Genetik GfG) with the topic “Genome editing using CRISPR” was held from September 4–6, at the Humboldt-Universität zu Berlin, organized by Ann Ehrenhofer-Murray, Anita Marchfelder, and Emmanuelle Charpentier.

In this article I take a poem by Lisa Bellear as a starting point for theorizing the possibility of a renovated feminism. I argue that the rhetorical questioning of the poem performs a mode of intersubjectivity in which the addressee/reader reflects upon their whiteness. The poem drives directly into the dense affect that saturates the troubled zone of cross-racial relations in contemporary Australia. If this zone is characterized by white anger and anxiety, it is also a zone of intense (...) `feeling' for the indigenous poet. Jean-Luc Nancy defines literature as the act of the `opening [of] community to itself', that is, of communicating our being-in-common. The cross-racial encounter that Bellear brokers between an indigenous and a white woman through the performance of address in this poem is not entirely comfortable or governable. I discuss how my students find this poem so confronting, and the fact that this discomfort underlines the necessity for a pedagogy that accommodates what Spivak refers to as `moments of bafflement'. (shrink)